Focal Myositis Localised in Gastrocnemius Muscle: is it Different from Isolated Gastrocnemius Myositis? A Case Report

IS, Son; JS, Kim; Yoo, Seung Jin; MS, Kang; CL, Hyun

doi:10.5704/moj.2111.022

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…20 There are also cases described with unilateral focal myositis of the gastrocnemius muscle in a patient with no underlying Crohn's disease or other diseases. 21 Polymyositis may rarely present as a distal and asymmetrical weakness as reported by Sundaram et al 22 Their case report showed a progressive onset of leg muscle weakness associated with muscle atrophy, which required high dose of steroids and immunosuppressants therapy with improvement, rather than complete resolution of the symptoms. The authors suggested that there is a small distinct group of patients with polymyositis, where distal and asymmetrical muscle weakness is the presenting feature.…”

Section: Discussionmentioning

confidence: 91%

Acute distal and symmetrical myositis of uncertain aetiology-a case report and literature review

Kazi,

Mehmed,

Chen

et al. 2023

Preprint

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Introduction: Myositis is a clinical condition with a wide spectrum clinical presentation and the classification in the literature is less clear. Case presentation: We present a case of 33 years old woman with acute history of pain and swelling of both calf muscles. Her investigations confirmed acute bilateral myositis. She responded well to conservative management with full recovery. This case is likely to represent a benign acute childhood myositis (BACM) with an adult onset. Although BACM is common in children up to the age of 12 years, there is an increasing trend of presentation in adults. BACM is a self-limited condition with good prognosis without specific treatment and the diagnosis is largely based on clinical features. Therefore, clinicians should be aware of this type of myositis in adults to avoid unnecessary invasive investigations. Conclusion: BACM may be changing pattern with an increasing shift of clinical presentation in adults. It is a self-limited condition, which does not need invasive investigations. There is still need for future research to precisely classify the clinical presentation of myositis.

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Section: Discussionmentioning

confidence: 91%

Acute distal and symmetrical myositis of uncertain aetiology-a case report and literature review

Kazi,

Mehmed,

Chen

et al. 2023

Preprint

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“…Of all these conditions, only rare distal muscular dystrophies and inclusion body myositis are known to cause isolated lower leg myositis and inclusion body myositis is almost exclusively found in adults. When present in adults, symptomatic lower leg myositis is typically unilateral and involves the gastrocnemius, vastus lateralis, and adductor muscles [ 20 , 21 ]. Systemic rheumatologic diseases such as juvenile dermatomyositis and polymyositis are often more proximal in nature, while vasculitis typically includes systemic symptoms and would be unlikely to cause regional muscle inflammation isolated to symmetric regions.…”

Section: Discussionmentioning

confidence: 99%

Why so low? An unusual case of myositis in a child

et al. 2023

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Background Sarcoidosis is characterized by non-caseating epithelioid granulomas in various tissues throughout the body, most commonly the lung. Non-caseating granulomas may be seen in skeletal muscle, though typically asymptomatic and under-recognized. While rare in children, there is a need to better characterize the disease and its management. Here we present a 12-year-old female with bilateral calf pain who was ultimately found to have sarcoid myositis. Case Presentation A 12-year-old female presented to rheumatology with significantly elevated inflammatory markers and isolated lower leg pain. MRI of the distal lower extremities demonstrated extensive bilateral myositis with active inflammation, atrophy, and to a lesser extent fasciitis. This distribution of myositis in a child garnered a broad differential requiring a systematic evaluation. Ultimately, muscle biopsy revealed non-caseating granulomatous myositis with perivascular inflammation, extensive muscle fibrosis, and fatty replacement of the muscle with a CD4+ T cell predominant, lymphohistiocytic infiltrate consistent with sarcoidosis. Review of histopathology from age 6 of an extraconal mass resected from her right superior rectus muscle further confirmed the diagnosis. She had no other clinical symptoms or findings of sarcoidosis. The patient improved significantly with methotrexate and prednisone, though flared again after self-discontinuation of medications and was subsequently lost to follow-up. Conclusion This is the second reported case of granulomatous myositis associated with sarcoidosis in a pediatric patient, and the first to present with a chief complaint of leg pain. Increased knowledge of pediatric sarcoid myositis within the medical community will enhance recognition of the disease, improve the evaluation of lower leg myositis, and advance outcomes for this vulnerable population.

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Focal Myositis Localised in Gastrocnemius Muscle: is it Different from Isolated Gastrocnemius Myositis? A Case Report

Cited by 2 publications

References 3 publications

Acute distal and symmetrical myositis of uncertain aetiology-a case report and literature review

Acute distal and symmetrical myositis of uncertain aetiology-a case report and literature review

Why so low? An unusual case of myositis in a child

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